On Delirium Tremens. 



355 



his head, upon attempting to get 

 out of bed ; spoke rationally this 

 morning at 7 o'clock a. m., since 

 which he has been lying in a 

 state of stupor, muttering; sub- 

 sultus tendinum ; pupils contract- 

 ed ; face livid ; skin and head hot ; 

 rapid pulse. 



3rd morning — died at 3 o'clock 



No. 17. July, age 38.— En- 

 gineer of a steamer ; a constantly 

 hard drinker ; has had delirium 

 tremens since 2 o'clock p. m. of 

 yesterday. 



Symptoms. — Great tremor; in- 

 coherent manner; impaired arti- 

 culation ; moist, cool skin ; full 

 pulse ; parched mouth ; vomiting ; 

 tender epigastrium ; palpitation. 



1st evening — has slept. 



2nd morning — much the same ; 

 short periods of sleep only ; per- 

 spiring skin; vomiting: evening — 

 incoherent and wild ; wandering 

 about the room ; bounding irri- 

 table pulse ; perspires freely. 



3rd morning — has remained 

 much the same all night, and is so 

 now : evening — has become very 

 violent ; talking deliriously, so 

 that, in the absence of the pro- 

 per means of control, it has been 

 necessary, for the safety of the 

 sick in Hospital, to use con- 

 straint by tying his arms and 



and Jalap ; turpentine enemata ; 

 ice and cold effusion upon head ; 

 blister upon head; repeat sina- 

 pisms, pediluvium, &c. 

 Post Mortem Examination nine 

 hours after death. 

 Head. — Dark blood poured out 

 very largely from the divided 

 scalp during the process of open- 

 ing the head ; effusion upon the 

 superior surface of the brain, 

 within the cavity of the arach- 

 noid ; three ounces of serum al- 

 together found at the base and 

 within the ventricles. Milkiness 

 and thickening of the arachnoid 

 membrane superiorly. Vessels 

 of the brain congested; an apo- 

 plectic cell filled with coagula of 

 the size of a Spanish nut, at the 

 inferior part and right side of the 

 anterior lobes. 



No. 17. 1st day — effervescing 

 draught with Tinct : Opii : M. xx. 

 2 dis. hor. until sleep: evening — 

 has had five doses, (vomiting 

 now and then) repeat the medi- 

 cine twice. 



2d morning — a purging draught, 

 c. Tinct : Opii : M. xx. ice to 

 head, sinapisms abdom. 



Evening and night — Tinct : 

 Opii: 5j. Omn: hor. to seven 

 times. 



3rd morning — Calomel and Ja- 

 lap, blister nuchse ; repeated small 

 does of tartar emetic and lauda- 

 num. 



Evening — Tr : Opii : 5j« Omn : 

 hor. a little brandy and water, 

 (he refused the laudanum several 

 times.) 



Night. — blister to vertex. 



